Gastric Ulcer Complications after the Introduction of Proton Pump Inhibitors into Clinical Routine: 20-Year Experience

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Abstract

Background: The aim of this study was to analyze the admissions and the management of peptic ulcer disease (PUD) in a tertiary care surgical center. Methods: We evaluated the medical records of all patients admitted to the University Hospital of Tübingen, Germany, for treatment of PUD during 1989-2008. Patients were included into the study if the diagnosis was verified endoscopically or surgically. Annual number of admissions, length of hospitalization, mortality rate, age, rate of non-steroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitor (PPI) medication, rate of Helicobacter pylori infection, and complications of PUD and surgery performed were recorded. Data were analyzed by descriptive analyses, Pearson's chi-square test, and regression analysis. Results: This study included 614 admissions. The number of annual admissions (31 ± 12), the length of hospitalization (9 ± 3 days), and the mortality rate (5 ± 4% per year) remained constant, whereas the age increased (1989: 52 ± 14 years vs. 2008: 67 ± 16 years). The rates of patients with H. pylori infection (47 ± 28% per year), NSAIDs treatment (29 ± 15% per year), and PPI treatment (31 ± 27% per year) remained constant. The most frequent PUD complication was hemorrhage (42 ± 16% per year), followed by perforation (9 ± 8% per year). During 1999-2008, more hemorrhages (125 vs. 121; p < 0.05) and perforations (40 vs. 21; p < 0.05) were registered than during 1989-1998. The rate of emergency surgery increased from 70% during 1989-1998 to 87% during 1999-2008. In contrast, elective surgery decreased from 21% during 1989-1998 to 7% during 1999-2008. Ulcer excision and oversewing was the most frequent surgical procedure performed (59%), with decreasing rates of acid-reducing surgery. Conclusion: Despite recent advances in PUD management, ulcer hemorrhage and perforation remain a significant health burden and a surgical disease.

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Author and article information

Journal

Journal ID (publisher-id): VIS

Journal ID (pmc): VIS

Journal ID (doi): 10.1159/issn.2297-4725

Title: Visceral Medicine

Publisher: S. Karger AG

ISBN: 978-3-318-06002-7

ISBN: 978-3-318-06003-4

ISSN (Print): 2297-4725

ISSN (Electronic): 2297-475X

Publication date Subscription-year: 2017

Publication date (Print): June 2017

Publication date (Electronic): 16 June 2017

Volume: 33

Issue: 3

Pages: 221-226

Affiliations

^aDepartment of General, Visceral and Transplant Surgery, University Hospital of Tübingen, Tübingen, Germany; ^bDepartment of General and Visceral Surgery, Medical Center of Konstanz, Konstanz, Germany; ^cDepartment of Traumatology and Reconstructive Surgery, BG Trauma Center, University of Tübingen, Tübingen, Germany

Author notes

*Dr. med. Markus A. Küper, Sektion Traumatologie und Rekonstruktive Chirurgie, BG Klinik - Berufsgenossenschaftliche Unfallklinik Tübingen, Schnarrenbergstraße 95, 72076 Tübingen, Germany, mkueper@bgu-tuebingen.de

Article

Publisher ID: 475450 Pmcid ID: PMC5527226 Other ID: Visc Med 2017;33:221-226

DOI: 10.1159/000475450

PMC ID: PMC5527226

PubMed ID: 28785572

SO-VID: 33c94b23-eddc-4980-8a43-7491b2a9fc97

License:

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

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Figures: 4, Tables: 4, References: 26, Pages: 6

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